title: Assessing proxy reports: agreement between children with asthma and their caregivers on quality of life.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) questionnaires are important tools to evaluate health status in children with asthma; however, children with asthma and their caregivers have shown only low to moderate agreement in their responses.
  
  
  OBJECTIVE
  To analyze the agreement between children with asthma and their caregivers on HRQOL, specifically in the domains of activity limitation, emotional function, and overall quality of life (QOL).
  
  
  METHODS
  We enrolled 79 pediatric patients (ages 5-17 years) with asthma (53 with acute asthma and 26 with refractory asthma) and their caregivers. Children completed the Pediatric Asthma Quality of Life Questionnaire, and caregivers completed the Pediatric Asthma Caregiver's Quality of Life Questionnaire (potential score, 1-7; higher scores indicate better QOL). We used paired t test to examine differences in child and caregiver responses, Pearson correlation to describe patterns of agreement, and multivariate analysis to evaluate the effect of sex, age, and ethnicity on differences in child and caregiver responses.
  
  
  RESULTS
  Children with asthma and their caregivers reported similar scores and demonstrated moderate correlation in emotional function and overall QOL. Children reported a significantly better QOL than their caregivers in response to questions about activity limitation (mean score, 4.62 vs 3.49; P < .001). Male children were more likely to differ from their caregivers than females, especially in regard to activity limitation.
  
  
  CONCLUSIONS
  Although caregivers of children with asthma can provide useful proxy information about QOL, their responses cannot be substituted for their children's reports regarding activity limitation. Clinicians and researchers should ask both children and their caregivers about asthma-specific QOL.
authors.affiliation: Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. burksm@livemail.uthscsa.edu
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Burks
authors.forename: Edward G
authors.initials: EG
authors.lastname: Brooks
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Hill
authors.forename: Jay I
authors.initials: JI
authors.lastname: Peters
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000523:psychology*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires